Adcirca

Last Reviewed: Nov 11, 2024

Warnings

Adcirca Risks, Warnings, and Complications

Adcirca (tadalafil) can cause or worsen health problems in certain people. Talk to your doctor or pharmacist about other treatment options for pulmonary arterial hypertension if you are at an increased risk of complications from this drug. Some of the risks of Adcirca use include:

HYPOTENSION: Adcirca (tadalafil) has vasodilatory properties, meaning it dilates or relaxes blood vessels. This can cause transient hypotension (low blood pressure). Your doctor will carefully weigh the benefits versus risks of prescribing Adcirca if you have a history of cardiovascular disease and could be adversely affected by the vasodilatory effects of Adcirca. The risk of low blood pressure is especially high in people with preexisting hypotension, left ventricular outflow obstruction, or autonomic dysfunction. Tell your doctor if you are on high blood pressure medications (which also have blood pressure-lowering effects).
WORSENING PULMONARY VENO-OCCLUSIVE DISEASE: Taking a pulmonary vasodilator such as Adcirca (tadalafil) can worsen cardiovascular status in people with pulmonary veno-occlusive disease (PVOD). This is a rare subtype of pulmonary arterial hypertension in which there is progressive blockage of the small veins in the lungs, leading to increased blood pressure in the pulmonary artery and right-sided heart failure. There is no clinical data available on the use of Adcirca in patients with pulmonary veno-occlusive disease. Therefore, Adcirca is not prescribed to individuals with this condition. Tell your doctor immediately if you develop swelling in the legs or abdomen, shortness of breath, or difficulty breathing while on this medicine.
CARDIOVASCULAR AND CEREBROVASCULAR RISKS: There are reports of serious cardiovascular events, including chest pain, palpitations, fast heart rate, heart attack, stroke, and sudden cardiac death in association with tadalafil use. Many of these events occurred in patients with preexisting cardiovascular risk factors and occurred during or shortly after sexual activity. Scientists do not know if these events are directly related to tadalafil use, underlying cardiovascular risk factors, or sexual activity. Seek emergency medical attention if you develop chest pain, shortness of breath, or other serious symptoms after taking Adcirca (tadalafil).
VISION LOSS: There are reports of sudden vision loss due to a complication called non-arteritic anterior ischemic optic neuropathy (NAION) in people who took phosphodiesterase type 5 (PDE-5) inhibitors, including tadalafil, to treat erectile dysfunction. This can result in decreased vision or even permanent loss of vision. Most patients, but not all, who developed this complication had underlying risk factors for NAION. Studies suggest that PDE5 inhibitor use can lead to an approximately 2-fold increase in the risk of NAION. Tell your doctor if you have any history of eye disease before starting Adcirca (tadalafil).
HEARING LOSS: There are reports of tinnitus (ringing in the ears), dizziness, sudden decreased hearing, and sudden hearing loss in patients taking tadalafil. It is unclear if these effects are directly related to the use of PDE5 inhibitors. Stop taking Adcirca and seek emergency medical care if you develop any hearing changes.
USE WITH OTHER PDE5 INHIBITORS: The active ingredient in Adcirca is tadalafil, which is also sold as Cialis to treat erectile dysfunction. Taking Adcirca with other PDE5 inhibitors may not be safe. Check with your healthcare provider before taking other medications from this drug class, for example, Cialis (tadalafil) or Viagra (sildenafil).
PROLONGED ERECTION: There are reports of painful, prolonged erections lasting more than 4 hours in people who took tadalafil. This condition is called priapism and is a medical emergency. Risk factors for priapism include sickle cell anemia, leukemia, multiple myeloma, and anatomical deformities in the penis, such as penile angulation, cavernosal fibrosis, or Peyronie's disease. Seek emergency medical care if you develop a painful or prolonged erection. Without treatment, priapism can result in irreversible damage to erectile tissue.

Precautions Before Starting Adcirca

Tell your doctor if you have ever had an allergic reaction to tadalafil (Adcirca, Tadliq, Cialis), any of the active or inactive ingredients in tadalafil tablets or liquid suspension, other PDE5 inhibitors such as sildenafil (Viagra), vardenafil (Levitra), or avanafil (Stendra), or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medicines, over-the-counter medicines, dietary supplements, and herbal products. This can help avoid potentially dangerous interactions between your medications.

Give your doctor a complete medical history. Adcirca may not be safe for people with certain medical conditions, such as smoking; a painful or prolonged erection lasting more than 4 hours; recent diarrhea, vomiting, excessive sweating, or dehydration (lack of enough fluids); pulmonary veno-occlusive disease (PVOD) or blockage of veins in the lungs; abnormal shape of the penis; high cholesterol; diabetes; high blood pressure or low blood pressure; irregular heartbeat; angina (chest pain); heart attack; heart failure; stroke; stomach ulcers; problems with blood circulation; bleeding disorders; problems with blood cells such as sickle cell disease; cancers such as multiple myeloma or leukemia; kidney disease; liver problems; a personal or family history of eye conditions such as retinitis pigmentosa; sudden vision loss; or sudden hearing loss.

If you are a woman taking Adcirca to treat pulmonary arterial hypertension, tell your doctor if you are pregnant, could be pregnant, or are planning a pregnancy soon. Also, tell your doctor if you plan to breast-feed an infant.

Precautions During Use of Adcirca

Keep all your medical and lab appointments while on treatment with Adcirca (tadalafil).

It can take several weeks for Adcirca to improve exercise ability. Continue taking Adcirca even if you feel well. This medicine can improve your exercise capacity (ability to do physical activity without shortness of breath or dizziness), but will not cure the underlying medical condition.

Avoid drinking alcoholic beverages while taking tadalafil. Drinking large amounts of alcohol while on Adcirca (tadalafil) can increase the risk of side effects such as headache, dizziness, fast heartbeat, and low blood pressure.

Tell your doctor if you become pregnant while taking Adcirca.

Tell all your doctors you are on Adcirca (tadalafil), including before any surgical procedures or dental treatments. Tell healthcare providers you are on tadalafil if you need emergency medical treatment for a heart condition.

Adcirca Drug Interactions

Taking Adcirca (tadalafil) with certain other drugs can affect how the medications work. Interactions between Adcirca and other medications may increase the risk of severe adverse effects. Your healthcare professional may change the dose, monitor you carefully for side effects, or switch you to a different medication if you are at risk of drug interactions.

Tell your doctor if you are currency taking or have recently taken the following medicines. You should not take them at the same time as tadalafil:

Guanylate cyclase stimulators such as riociguat (Adempas), which are prescribed for pulmonary hypertension.
Nitrates such as isosorbide mononitrate (Monoket), isosorbide dinitrate (Isordil), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). These medicines are prescribed for angina (chest pain) and heart disease and come in the form of tablets, sublingual tablets, patches, sprays, ointments, and pastes.

Also, tell your doctor if you are taking street (recreational) drugs called poppers that contain nitrates such as nitrite, amyl nitrate, and butyl nitrate. Your provider will likely not prescribe tadalafil if you are using street drugs that contain nitrates.

Tadalafil is also available under the brand name Cialis to treat erectile dysfunction. Do not take Adcirca and Cialis at the same time.

Tell your doctor and pharmacist if you are on the following prescription and nonprescription medications, which can also have interactions with tadalafil:

Alpha blockers such as doxazosin (Cardura), prazosin (Minipress), alfuzosin (Uroxatral), dutasteride (Avodart, in Jalyn), tamsulosin (Flomax, in Jalyn), silodosin (Rapaflo), and terazosin, which are used to treat high blood pressure and enlarged prostate gland
Medications used to treat heart arrhythmias such as amiodarone (Cordarone, Pacerone)
Antifungal drugs such as itraconazole (Onmel, Sporanox), fluconazole (Diflucan), ketoconazole (Ketozole, Nizoral, Extina, Xolegel), voriconazole (Vfend), and griseofulvin (Grifulvin, Gris-PEG)
Antiemetic drugs such as aprepitant (Emend) used to treat nausea and vomiting related to surgery or chemotherapy
Antiepileptic drugs such as carbamazepine (Tegretol, Carbatrol, Epitol, others), phenobarbital, and phenytoin (Dilantin, Phenytek)
Certain antibiotics such as clarithromycin (Biaxin, in Prevpac), erythromycin (E.E.S., E-Mycin, Erythrocin), telithromycin (Ketek), rifabutin (Mycobutin), and rifampin (Rimactane, Rifadin, in Rifamate, in Rifater)
Calcium channel blockers such as diltiazem (Cartia, Cardizem, Tiazac, others) and verapamil (Calan, Covera, Verelan, in Tarka)
HIV medications such as efavirenz (Sustiva, in Atripla), indinavir (Crixivan), ritonavir (Norvir, in Kaletra), nelfinavir (Viracept), and nevirapine (Viramune)
Cholesterol-lowering drugs such as lovastatin (Altocor, in Advicor)
Drugs prescribed to treat high blood pressure
Antidepressants such as nefazodone and sertraline (Zoloft)
Medications prescribed for erectile dysfunction
Other medicines prescribed for pulmonary arterial hypertension, such as bosentan (Tracleer) and others
Herbal products such as St. John's wort

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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